Immune-Related Oral, Otologic, and Ocular Adverse Events

Area of Science:

• Oncology
• Immunology
• Ophthalmology
• Otolaryngology

Background:

• Immunotherapy, including immune checkpoint inhibitors, represents a significant advancement in cancer treatment.
• The novel mechanisms of action for these agents mean their toxicity profiles are still being fully elucidated.
• Understanding immune-related adverse events (irAEs) is crucial for safe and effective immunotherapy use.

Purpose of the Study:

• To review the clinical manifestations of oral, audiovestibular, and ocular immune-related adverse events (irAEs) associated with emerging immunotherapy agents.
• To provide an overview of the known toxicities and their potential impact on patients undergoing cancer therapy.

Main Methods:

• A review of current evidence on the clinical manifestations of irAEs.
• Analysis of reported adverse events in patients treated with immunotherapy agents.
• Comparison of irAE prevalence with conventional cancer therapies.

Main Results:

• While overall oral toxicities like mucositis are lower with immunotherapy than chemotherapy or radiation, new events such as bullous pemphigoid can occur.
• Audiovestibular dysfunction, including sensorineural hearing loss, is a potential irAE with limited treatment options.
• Ocular irAEs are common, mostly mild (e.g., blurred vision), but serious sight-threatening events (e.g., optic neuropathy) are infrequent but possible.

Conclusions:

• Emerging immunotherapies have distinct toxicity profiles, including specific oral, audiovestibular, and ocular irAEs.
• While generally less toxic orally than traditional treatments, novel irAEs require careful monitoring.
• Prompt recognition and management of audiovestibular and ocular irAEs are essential to prevent long-term complications.